| Innovative Wound Care Inc | |
|
19615 Dinner Key Dr Boca Raton FL 33498-4523 | |
| (561) 990-6033 | |
| Not Available |
| Full Name | Innovative Wound Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19615 Dinner Key Dr, Boca Raton, Florida |
| Authorized Official Name and Position | Shamil Mardanov (PRESIDENT) |
| Authorized Official Contact | 4408294477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Wound Care Inc 19615 Dinner Key Dr Boca Raton FL 33498-4523 Ph: () - | Innovative Wound Care Inc 19615 Dinner Key Dr Boca Raton FL 33498-4523 Ph: (561) 990-6033 |
| NPI Number | 1649958752 |
|---|---|
| Provider Enumeration Date | 07/10/2023 |
| Last Update Date | 07/10/2023 |
| Medicare PECOS PAC ID | 2769846625 |
|---|---|
| Medicare Enrollment ID | O20230911002067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649958752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Cedric Emden Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356534994 PECOS PAC ID: 9931243128 Enrollment ID: I20110929000686 |
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